1. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Patient’s Mobility: Transfer Skills Unit 16

2. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Spell and define terms. List at least seven factors to consider, before lifting or moving a patient, to determine whether additional equipment or assistance is necessary. 2

3. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives Apply the principles of good body mechanics and ergonomics to moving and transferring patients. List the guidelines for safe transfers. Describe the difference between a standing transfer and a sitting transfer. 3

4. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Objectives List the guidelines for using the manual handling sling and pivot disk. Demonstrate correct application of a transfer belt. 4

5. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Introduction As a nursing assistant, you will work with many patients who have impaired mobility. In Unit 15, you learned how to move and position patients in bed. In this unit, you will learn how to transfer patients. 5

6. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Patient lifts and transfers are considered tasks with the highest risk of injury because: –Workers end up in awkward positions and confined spaces –Workers are bending or reaching while the back is flexed 6

7. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Factors that further increase the risk of injury are: –History of previous back injury (greatest risk) –Patient weight –Transfer distance –Lateral patient transfers –Unpredictable patient behavior –Stooping, bending, and reaching 7

8. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Although the nurse or therapist selects the method of transfer –You must to determine if you will need another person or piece of equipment to assist you 8

9. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Key elements for you to consider are: –Patient’s ability to assist with the procedure –Patient’s ability to bear weight –Patient’s upper-extremity strength –If a sliding board or certain other transfers are used 9

10. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Key elements for you to consider are: –Patient’s ability to cooperate and follow directions –Patient’s size (height and weight) compared with your size 10

11. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Key elements for you to consider are: –If the patient is larger than you are You may need help from another assistant or a mechanical device –If the patient is smaller than you are, is dependent, or cannot cooperate You may also need help 11

12. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Key elements for you to consider are: –Wounds –Surgical sites –Catheters, IVs, tubes, contractures, etc., that restrict or interfere with mobility Always get help if there is danger of removing or dislodging a tube during transfer 12

13. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Key elements for you to consider are: –Special physician orders or therapy recommendations for transfers and positioning Such as you would see for a patient who has had hip surgery 13

14. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Eleven states have passed laws requiring facilities to implement safe patient handling and movement programs. Many facilities have implemented “no lift” policies –“No manual lifting” should be done 14

15. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Facilities with “no lift” or “zero lift” policies –Usually depend on mechanical aids to reduce friction when moving a patient 15

16. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nursing Assistant Safety Some use a combination of mechanical, electrical, and ceiling-mounted lifts for moving patients vertically. Many facilities require the use of transfer (gait) belts for all assisted transfers. 16

17. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of Transfers Basic types of transfers are: –Standing transfer –Sitting transfer (sliding board) –Lateral transfer –Vertical transfer Done with a mechanical lift 17

18. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Transfers A transfer belt –Webbed belt 1½ to 2 inches wide and about 54 to 60 inches long –Bariatric belts are 72 inches long –Assistive and safety device used to transfer or ambulate patients 18

19. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Transfers During transfer and when wheelchair is parked –Always position small front wheels facing forward and lock brakes Refer to Figure 16-3 19

20. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Transfers 20

21. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Transfers A sliding board is a plastic or wooden board that is about 2 feet long with a slippery surface It is used for a sitting lateral transfer 21

22. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Stretcher Transfers Used to move a patient from his or her room to another room for surgery, treatment, or diagnostic testing Procedure may be very frightening to the patient –Assure the patient that the procedure is safe 22

23. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Moving the Patient with a Mechanical Lift For moving heavy patients who have little or no ability to assist Safer for both patient and nursing assistant 23

24. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Moves patient from one surface to another by means of a vertical transfer Many types of mechanical lifts are used 24 Moving the Patient with a Mechanical Lift

25. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Other Common Moving Devices Rollator Merry Walker® Merry Motivator® Merry Stand By Me® Standing lifter Swivel disks 25

26. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Manual Handling Slings Small fabric or plastic sling (about 20 inches long and 8 inches wide) with handles on the long ends Has many patient handling applications Eliminates pulling and tugging on a patient’s body and makes the task easier for the nursing assistant 26

27. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Manual Handling Slings Reduces risk of injury. The manual handling sling will not make you stronger, and should not be used for moving patients who would otherwise be too heavy 27

28. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Toilet Transfers Bladder is emptied much more efficiently if a patient can use a toilet or commode rather than a urinal or bedpan To use the toilet –Patient must possess transfer skills 28

29. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Tub Transfers In the institutional setting –A shower with chair or a tub with hydraulic lift is available If the patient is at home –A tub chair, a rail on the wall beside the tub, and slip-proof mats in the tub are needed for safety 29

30. © 2016 Cengage Learning ®. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Car Transfers You may need to assist a patient –Transferring into a car when he or she is discharged from the hospital If you are working in the patient’s home –It may be your responsibility to assist the patient when getting in and out of a car 30